CDC guidelines part deux

[geauxg8rs]

C.D.C. Proposes New Guidelines for Treating Pain, Including Opioid Use (Published 2022)

The agency threw out previous recommended limits on doses but encouraged “nonopioid therapies” wherever possible.

www.nytimes.com

Now we get to hear how we are undertreating pain, doc you can write my oxy 15 q 2 hour again. Thanks CDC!

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[SSdoc33]

C.D.C. Proposes New Guidelines for Treating Pain, Including Opioid Use (Published 2022)

The agency threw out previous recommended limits on doses but encouraged “nonopioid therapies” wherever possible.

www.nytimes.com

Now we get to hear how we are undertreating pain, doc you can write my oxy 15 q 2 hour again. Thanks CDC!

i dont pay for NYT (the hell you say), but i saw the headline. can you post the text?

 

[callmeanesthesia]

https://www.federalregister.gov/documents/2022/02/10/2022-02802/proposed-2022-cdc-clinical-practice-guideline-for-prescribing-opioids

Here’s the draft recommendation. Somehow much harder to find than news articles about it.

 

[Ducttape]

the Federal Register post only discusses that there is a process for updating the guidelines, not the actual suggested changes... yet.

 

[myrandom2003]

to echo Ducttapes comment, no proposal yet.

Process for the Development of the 2022 Clinical Practice Guideline for Prescribing Opioids for Pain | Opioids | CDC

www.cdc.gov

same thing as above but just prettier

 

[geauxg8rs]

It doesn’t matter what the final proposal is. The news is just going to report that there isn’t a hardfast number anymore. Then patients will complain to us that we aren’t treating their pain despite “being allowed to.”

 

[Agast]

You should never have told your patients you’re not writing stronger meds because the government won’t allow it. That’s weak sauce. I tell them frankly when those doses are not appropriate. Seek a second opinion if they disagree yadda yadda. Some patients with unique circumstances may require more medication. Use your best judgement.

 

[geauxg8rs]

I agree. I do what I think is best. But It will not prevent the argument and frustration when I keep saying no but they keep
Saying “well The CDC says you can….”

 

[myrandom2003]

ask them if they are vaccinated. if they say no, then their CDC argument is moo

 

[MitchLevi]

Wait.

There are doctors here who say they can't do X, Y or Z bc the CDC says so?

"I can't write higher than 90 MED bc the CDC says I can't."

Why not just say no?

"I don't prescribe high dose opiates. Period. If that's what you think you need, I know a guy..."

We've had a local med management clinic fire all unvaccinated pts without any warning or a Rx to bridge.

 

[clubdeac]

the CDC is truly a joke, that's become very evident over the last 2 years

 

[Ducttape]

it lost some of its credibility when the trump administration decided to politicize the organization.

should have stayed strictly science based, but what the CDC was saying didnt fit into the false political narrative pushed by the former admin, political wonks took over. that should not be allowed to happen again, but all over, public health is being hijacked for political gain.

 

[geauxg8rs]

It lost credibility with its first opioid guidelines and their reputation has eroded from there under both dem then gop and now dem regimes

 

[deleted875186]

Agreed, like every aspect of the government it has become political, I think the majority of the public has lost confidence in the CDC.

 

[drusso]

I will follow the science.

 

[Doctodd]

I will follow the science.

Fauci represents science.....or so he said

 

[DrMDAware]

Wait.

There are doctors here who say they can't do X, Y or Z bc the CDC says so?

"I can't write higher than 90 MED bc the CDC says I can't."

Why not just say no?

"I don't prescribe high dose opiates. Period. If that's what you think you need, I know a guy..."

We've had a local med management clinic fire all unvaccinated pts without any warning or a Rx to bridge.

Wouldn’t that be considered patient abandonment to fire patients without warning or a bridge?

 

[DODOCSS]

Fauci represents science.....or so he said

he is science

 

[deleted131481]

I've seen a massive shift in prescribing patterns since 2016. There are many fewer high dose opioid regimens around either by PCP or local pain docs. There is much more awareness with physicians, patients, and in the community of the untoward effects of opioids.

The CDC guidelines has its issues but overall has been a catalyst in the right direction.

 

[deleted875186]

I've seen a massive shift in prescribing patterns since 2016. There are many fewer high dose opioid regimens around either by PCP or local pain docs. There is much more awareness with physicians, patients, and in the community of the untoward effects of opioids.

The CDC guidelines has its issues but overall has been a catalyst in the right direction.

CDC guidelines were good in my opinion, they should have kept the dose limit recommendations but just toned down the language. I think dialed back the dose limits makes them look bad.

 

[MitchLevi]

I don't have a problem with the CDC guidelines, but physicians should have already been practicing in similar manner.

Prescribing over 90 MED should be extremely uncommon. The highest I have in my practice is Perc 10/325mg TID, and that's less than 10 pts.

I can't say there's a good reason to go higher than that in 99% of cases. There's a local guy who routinely goes over 90 MED. If I see one of his pts there's always some BS. Always...

Edit - Not cancer...Give them what they need.

There's probably a link between higher doses of opiates and greater spread of malignancy.

 

[Doctodd]

CDC should have recommended aspirin after Covid or Covid vaccine due to all the hypercoagulability catastrophic complications.

 

[deleted875186]

I don't have a problem with the CDC guidelines, but physicians should have already been practicing in similar manner.

Prescribing over 90 MED should be extremely uncommon. The highest I have in my practice is Perc 10/325mg TID, and that's less than 10 pts.

I can't say there's a good reason to go higher than that in 99% of cases. There's a local guy who routinely goes over 90 MED. If I see one of his pts there's always some BS. Always...

Edit - Not cancer...Give them what they need.

There's probably a link between higher doses of opiates and greater spread of malignancy.

Agreed, if pain is not controlled with 50MME or less, opioids aren’t working very well. Even 10 mg oxycodone at a time is quite a high dose. I agree most of these high dose patient always some questionable behavior or history.

 

[drusso]

it lost some of its credibility when the trump administration decided to politicize the organization.

should have stayed strictly science based, but what the CDC was saying didnt fit into the false political narrative pushed by the former admin, political wonks took over. that should not be allowed to happen again, but all over, public health is being hijacked for political gain.

The CDC Guidelines would have more credibility if they kicked off Roger Chou.